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Improved diabetes control in the elderly delays global cognitive decline

  • JNHA: Clinical Neurosciences
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To examine whether improved diabetes control is related to better cognitive outcomes.

Design

Randomized control trial.

Setting

A randomized trial of telemedicine vs. usual care in elderly persons with type 2 diabetes.

Participants

Participants were 2169 persons 55 years and older with type 2 diabetes from New York City and Upstate New York.

Intervention

The diabetes case management intervention was implemented by a diabetes nurse, via a telemedicine unit in the participant’s home, and in coordination with the primary care physician.

Measurements

Hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low density lipoprotein cholesterol (LDL), were measured at a baseline visit and at up to 5 annual follow-up visits. Global cognition was measured at those visits with the Comprehensive Assessment and Referral Evaluation (CARE).

Result

In mixed models the intervention was related to slower global cognitive decline in the intervention group (p = 0.01). Improvements in HbA1c (p = 0.03), but not SBP or LDL, mediated the effect of the intervention on cognitive decline.

Conclusion

Improved diabetes control in the elderly following existing guidelines through a telemedicine intervention was associated with less global cognitive decline. The main mediator of this effect seemed to be improvements in HbA1c.

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Author information

Authors and Affiliations

  1. Department of Medicine, Columbia University, New York, NY, USA

    José A. Luchsinger, Walter Palmas & S. Shea

  2. Department of Epidemiology, Joseph Mailman School of Public Health, Columbia University, New York, NY, USA

    José A. Luchsinger & S. Shea

  3. Research Division, Hebrew Home at Riverdale, Bronx, NY, USA

    J. A. Teresi, S. Silver, J. Kong & J. P. Eimicke

  4. Stroud Center, Columbia University, Columbia, USA

    J. A. Teresi

  5. New York State Psychiatric Institute, New York, NY, USA

    J. A. Teresi

  6. Joslin Diabetes Center and Division of Endocrinology, Diabetes and Metabolism, SUNY Upstate Medical University, Syracuse, NY, USA

    R. S. Weinstock

  7. Department of Veterans Affairs, VA Medical Center, Syracuse, NY, USA

    R. S. Weinstock

  8. Department of Biomedical Informatics, Columbia University, New York, NY, USA

    S. Shea

  9. Division of General Medicine, PH9East-105, 630 West 168th street, New York, NY, 10032, USA

    José A. Luchsinger

Authors
  1. José A. Luchsinger
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  4. S. Silver
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  6. J. P. Eimicke
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  7. R. S. Weinstock
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  8. S. Shea
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Ideatel Consortium

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Correspondence to José A. Luchsinger or Walter Palmas.

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FOR THE IDEATEL CONSORTIUM

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Luchsinger, J.A., Palmas, W., Teresi, J.A. et al. Improved diabetes control in the elderly delays global cognitive decline. J Nutr Health Aging 15, 445–449 (2011). https://doi.org/10.1007/s12603-011-0057-x

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  • DOI: https://doi.org/10.1007/s12603-011-0057-x

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